Information Collection

Development of CDC's Act Against AIDS Social Marketing Campaigns Targeting Consumers

IC 209289 under ICR 201301-0920-010 · OMB 0920-0840.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0840 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 2a Screening Instrument.docx	Other-WORD
Att 2b Exploratory-HIV Testing-IDI.docx	Other-WORD
Att 2c Exploratory-HIV Prevention-IDI.docx	Other-WORD
Att 2d Exploratory-Comm Aware-IDI.docx	Other-WORD
Att 2e Exploratory-PWP-IDI.docx	Other-WORD
Att 2f Consumer Msg Testing-IDI.docx	Other-WORD
Att 2g Consumer Concept Testing-IDI.docx	Other-WORD
Att 2h Consumer Materials Testing-IDI.docx	Other-WORD
Att 2i Exploratory-HIV Testing-FG.docx	Other-WORD
Att 2k Exploratory-HIV Comm Aware-FG.docx	Other-WORD
Att 2l Exploratory-HIV PWP-FG.docx	Other-WORD
Att 2j Exploratory-HIV Prevention-FG.docx	Other-WORD
Att 2m Consumer Concept Testing-FG.docx	Other-WORD
Att 2n Consumer Message Testing-FG.docx	Other-WORD
Att 2o Consumer MaterialsTesting.docx	Other-WORD
Att 2p Paper Pencil - HIV Testing.docx	Other-WORD
Att 2q Paper Pencil - HIV Prevention.docx	Other-WORD
Att 2r Paper Pencil - HIV Comm and Awarness.docx	Other-WORD
Att 2s Paper Pencil - HIV Prevention with Positives.docx	Other-WORD
Att 2t Intercept Guide.docx	Other-WORD
Supporting Statement A.docx Sup Sta A	IC Document
Supporting Statement B.docx Sup Sta B	IC Document
Att 1_Authorizing Legislation.pdf Att 1_Authorizing Legislation	IC Document
Att 3a Consent Form-Exploratory-IDI FG.docx Att 3a Consent Form-Exploratory-IDI FG	IC Document
Att 3b Consent Form-Msg Testing-IDI FG.docx Att 3b Consent Form-Msg Testing-IDI FG	IC Document
Att 3c Consent Form-Intercept.docx Att 3c Consent Form-Intercept	IC Document
Att 4 Data Management Ack.docx Att 4 Data Management Ack	IC Document
Att 5 Intercept Receipt Form.docx Att 5 Intercept Receipt Form	IC Document
Att 6 Messages.docx Att 6 Messages	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Development of CDC's Act Against AIDS Social Marketing Campaigns Targeting Consumers

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Att 2q Paper Pencil - HIV Prevention.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2f Consumer Msg Testing-IDI.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2g Consumer Concept Testing-IDI.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2h Consumer Materials Testing-IDI.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2i Exploratory-HIV Testing-FG.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2k Exploratory-HIV Comm Aware-FG.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2l Exploratory-HIV PWP-FG.docx	No	No	Fillable Printable
Other-WORD	Att 2j Exploratory-HIV Prevention-FG.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2m Consumer Concept Testing-FG.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2n Consumer Message Testing-FG.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2o Consumer MaterialsTesting.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2p Paper Pencil - HIV Testing.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2a Screening Instrument.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2b Exploratory-HIV Testing-IDI.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2c Exploratory-HIV Prevention-IDI.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2d Exploratory-Comm Aware-IDI.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2e Exploratory-PWP-IDI.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2r Paper Pencil - HIV Comm and Awarness.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2s Paper Pencil - HIV Prevention with Positives.docx	Yes	Yes	Fillable Printable
Other-WORD	Att 2t Intercept Guide.docx	Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,038

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	5,038	0	0	0	0	0
Annual IC Time Burden (Hours)	2,061	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Sup Sta A	Supporting Statement A.docx	11/06/2013
Sup Sta B	Supporting Statement B.docx	11/06/2013
Att 1_Authorizing Legislation	Att 1_Authorizing Legislation.pdf	11/06/2013
Att 3a Consent Form-Exploratory-IDI FG	Att 3a Consent Form-Exploratory-IDI FG.docx	11/06/2013
Att 3b Consent Form-Msg Testing-IDI FG	Att 3b Consent Form-Msg Testing-IDI FG.docx	11/06/2013
Att 3c Consent Form-Intercept	Att 3c Consent Form-Intercept.docx	11/06/2013
Att 4 Data Management Ack	Att 4 Data Management Ack.docx	11/06/2013
Att 5 Intercept Receipt Form	Att 5 Intercept Receipt Form.docx	11/06/2013
Att 6 Messages	Att 6 Messages.docx	11/06/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.